Bioethics

Video Series: John Harris Defends Gene-Editing in Human Embryos

Novel gene editing technologies, such as CRISPR/Cas9, allow scientists to make very precise changes in the genome of human embryos. This could prevent serious genetic diseases in future children. But the use of gene editing in human embryos also raises questions: Is it safe? Should prospective parents be free to choose the genetic characteristics of their children? What if they want to use gene editing to have a deaf child, or a child with fair skin and blue eyes? Should gene editing be regulated globally, or should each country have their own legislation? In this interview with Katrien Devolder, John Harris (Professor Emeritus, University of Manchester &  Visiting Professor in Bioethics, King’s College London) answers these and other questions, and defends the view that we have the strongest moral obligation to gene-edit human embryos, not only to prevent disease but also for the purpose of enhancement.

Pedophilia and Child Sexual Abuse Are Two Different Things — Confusing Them is Harmful to Children

By Brian D. Earp (@briandavidearp)

Republican politician Roy Moore has been accused of initiating sexual contact with a 14-year-old girl when he was in his early 30s. Social media sites have since exploded with comments like these:

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Video Series: Should We Pay People to Quit Smoking or Lose Weight?

Should we pay people to quit smoking or lose weight? Would paying them amount to coercion?  Is there a risk that if we start paying for healthy behaviour, its value will be corrupted? Is paying unhealthy people unfair to those who already lead healthy life styles? In this video interview (with Katrien Devolder),  Dr Rebecca Brown from the Oxford Uehiro Centre for Practical Ethics responds to these and other concerns and defends the use of financial incentives as a tool for health promotion.

Blade Runner 2049, Parfit and Identity

Julian Savulescu

 

Contains spoilers for both Blade Runner films. This is a longer version of a shorter piece without spoilers, Blade Runner 2049: Identity, Humanity, and Discrimination, in Pursuit 

Blade Runner 2049, like the original, is about identity, humanity and discrimination.

Identity and Humanity

In both films, bioengineered humans are known as replicants.  Blade Runners “retire” or kill these replicants when they are a threat to society. In the original, Blade Runner Rick Deckard (Harrison Ford) has all the memories and feelings of a human and believes himself to be a human, only at the end to discover he is a replicant. In the sequel, K (Ryan Gosling) is a replicant but comes to believe (falsely) that he is Deckard’s child. In Blade Runner 2049, we are left to watch K dying, realising his memories were implanted by Deckard’s daughter.

In both films we are left wondering what difference there is between a human and a replicant. In the original, rogue replicant Roy Batty (Rutger Hauer) saves Deckard’s life (as Deckard was trying to kill him) and delivers famous “Tears in the Rain” speech:

“I’ve seen things you people wouldn’t believe. Attack ships on fire off the shoulder of Orion. I watched C-beams glitter in the dark near the Tannhäuser Gate. All those moments will be lost in time, like tears in rain. Time to die.”

Roy comes across as more human than the humans in the film. Indeed, in a preceding scene, a thorn or spike appears through his hand reminiscent of Christ, whose own identity as fully human and fully divine has puzzled Theologians for two millenia.

Both films challenge what it is to be human. In 2049, K believes the child of Deckard might have a soul because it was born.

Who are we?

The films both raise fundamental questions about personal identity: who are we? What fundamentally defines the existence of a person from one moment to the next? In both films, there is the suggestion that the biological mass, the body, is not what matters but the mind. In the original, bioengineered Roy seems as human as Deckard, as human as someone could be. In 2049, the idea is extended further still: K’s girlfriend Joi is an AI but seems as real as the other characters and her death is equally tragic.

Derek Parfit died in January this year. He was the world’s most famous moral philosopher (and his favourite film was another Ridley Scott classic, The Duellists). One of his famous ideas is that “identity” is not what matters. He articulated this in his masterpiece, Reasons and Persons (Oxford: Clarendon Press, 1984). According to Parfit, what matters is psychological continuity and connectedness, that is, the unity of our mental states.

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A Fundamental Problem with Moral Enhancement

by Joao Fabiano

Moral philosophers often prefer to conceive thought experiments, dilemmas and problem cases of single individuals who make one-shot decisions with well-defined short-term consequences. Morality is complex enough that such simplifications seem justifiable or even necessary for philosophical reflection.  If we are still far from consensus on which is the best moral theory or what makes actions right or wrong – or even if such aspects should be the central problem of moral philosophy – by considering simplified toy scenarios, then introducing group or long-term effects would make matters significantly worse. However, when it comes to actually changing human moral dispositions with the use of technology (i.e., moral enhancement), ignoring the essential fact that morality deals with group behaviour with long-ranging consequences can be extremely risky. Despite those risks, attempting to provide a full account of morality in order to conduct moral enhancement would be both simply impractical as well as arguably risky. We seem to be far away from such account, yet there are pressing current moral failings, such as the inability for proper large-scale cooperation, which makes the solution to present global catastrophic risks, such as global warming or nuclear war, next to impossible. Sitting back and waiting for a complete theory of morality might be riskier than attempting to fix our moral failing using incomplete theories. We must, nevertheless, proceed with caution and an awareness of such incompleteness. Here I will present several severe risks from moral enhancement that arise from focusing on improving individual dispositions while ignoring emergent societal effects and point to tentative solutions to those risks. I deem those emergent risks fundamental problems both because they lie at the foundation of the theoretical framework guiding moral enhancement – moral philosophy – and because they seem, at the time, inescapable; my proposed solution will aim at increasing awareness of such problems instead of directly solving them.

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Organ Donation: Presumed Consent and Focusing on What Matters

Recent newspaper reports covered the story of Jemima Layzell, a 13 year old who died suddenly of a brain aneurysm in 2012. According to reports, shortly before Jemima died, the subject of organ donation had come up in discussions with her family, prompted by the death of a family friend in a car accident. As a result, Jemima’s family were confident she would have wanted her organs to be donated. Subsequently, Jemima’s kidneys, liver, lungs, pancreas, small bowel and heart were transplanted. This meant that a record eight people’s lives were saved, prolonged or dramatically enhanced as a consequence of Jemima’s and her family’s decision.

Decisions about organ donation are extremely difficult. Family members are approached about the prospect of donating their loved one’s organs at a time of extraordinary distress. Uncertainty about the wishes of the person who has died, along with confusion or scepticism about brain death criteria, religious or other spiritual beliefs about bodily integrity, fear about how donated organs will be used, and inability or unwillingness to engage with any form of decision-making can result in the refusal of family members to allow organs to be donated. In England, family members can prevent donation even when the individual has expressed a wish to donate her organs, for instance, by signing up to the organ donor register. Continue reading

‘Being a burden’: an Illegitimate Ground For Assisted Dying

The issue of the legality in England and Wales of physician-assisted suicide has recently been revisited by the Divisional Court. Judgment is awaited. The judgment of the Court of Appeal, granting permission for judicial review, is here.

The basic issue before the Court of Appeal was the same as that in Nicklinson v Ministry of Justice and R (Purdy) v DPP: does the right to determine how one lives one’s private life (protected by Article 8 of the European Convention on Human Rights)  confer a right to have an assisted death?

Many factors have been said to be relevant to decisions about assisted dying. They include intractable pain (rather a weak criterion, given modern palliative methods), hopeless prognosis – likely to result in death in a short time –  and simple autonomy (‘It’s my right to determine where, when, and in what circumstances I end my life, and that’s an end of the matter’). One factor, commonly in the minds of patients asking for help in ending their lives, but rarely mentioned by advocates of assisted dying, is that the patient feels that she is a burden to her family and carers. Continue reading

Talking Back to Science?

By Stephen Rainey

In June 2017, the European Court of Justice ruled that it was legal for a French citizen to sue a drug company for damages following a vaccination, and an illness. The ruling caused some consternation as it seemed a legal vindication of anecdote over scientific rigour.

This is a dramatic case, not least owing to the position in which vaccines find themselves, post Andrew Wakefield and the rise of the anti-vaxxer movement. Nevertheless, it forms a part of a wider narrative in which scientific activity is not always very open to questions from outside science. This broader theme is worth some scrutiny. Continue reading

Does Female Genital Mutilation Have Health Benefits? The Problem with Medicalizing Morality

Does Female Genital Mutilation Have Health Benefits? The Problem with Medicalizing Morality

By Brian D. Earp (@briandavidearp)

Please note: this piece was originally published in Quillette Magazine.

 

Four members of the Dawoodi Bohra sect of Islam living in Detroit, Michigan have recently been indicted on charges of female genital mutilation (FGM). This is the first time the US government has prosecuted an “FGM” case since a federal law was passed in 1996. The world is watching to see how the case turns out.

A lot is at stake here. Multiculturalism, religious freedom, the limits of tolerance; the scope of children’s—and minority group—rights; the credibility of scientific research; even the very concept of “harm.”

To see how these pieces fit together, I need to describe the alleged crime.

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Can We Trust Research in Science and Medicine?

By Brian D. Earp  (@briandavidearp)

Readers of the Practical Ethics Blog might be interested in this series of short videos in which I discuss some of the major ongoing problems with research ethics and publication integrity in science and medicine. How much of the published literature is trustworthy? Why is peer review such a poor quality control mechanism? How can we judge whether someone is really an expert in a scientific area? What happens when empirical research gets polarized? Most of these are short – just a few minutes. Links below:

Why most published research probably is false

The politicization of science and the problem of expertise

Science’s publication bias problem – why negative results are important

Getting beyond accusations of being either “pro-science” or “anti-science”

Are we all scientific experts now? When to be skeptical about scientific claims, and when to defer to experts

Predatory open access publishers and why peer review is broken

The future of scientific peer review

Sloppy science going on at the CDC and WHO

Dogmas in science – how do they form?

Please note: this post will be cross-published with the Journal of Medical Ethics Blog.

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